Individual
HERBERT LEE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10876 TARIN DR, JACKSONVILLE, FL 32218-4808
(904) 757-1407
(904) 757-1407
Mailing address
10876 TARIN DR, JACKSONVILLE, FL 32218-4808
(904) 757-1407
(904) 757-1407
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
680842596
FL
347C00000X
Private Vehicle
680842596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
680842596
—
FL
Enumeration date
05/15/2008
Last updated
05/15/2008
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